Evaluation of the risk of postoperative recurrence in patients with Chronic Subdural Haematoma according to volume, density and protein content of the haematoma: A retrospective study

Introduction: Chronic subdural haematoma is one of the common diseases encountered in neurosurgical practice. It is generally more common in the elderly patient population and its incidence is 14.1-20.6 per 100,000 per year. It has been described in the literature that recurrent haematoma develops in approximately 10% of operated patients followed up with closed drainage system. In this study, the effect of demographic, radiological and peripheral blood serum and haematoma biochemical characteristics on the risk of recurrent haematoma development was investigated. Material and Method: Patients who underwent surgery for chronic subdural haematoma between January 2019 and July 2023 in Dokuz Eylül University Department of Neurosurgery were retrospectively reviewed. A total of 84 patients were included in the study. Demographic characteristics of the patients, peripheral blood serum and intraoperative hematoma biochemistry values taken at the time of admission, preoperative and postoperative 1st day and 1st month CT scan radiological features were recorded and the effect on the development of recurrent haematoma in the 6-month follow-up of the patients was investigated. Results: In our study, the youngest patient was 36 years old, the oldest patient was 93 years old and the mean age of the patients was 70.39 (± 12.98). Twenty (23.8%) of the patients were female and 64 (76.2%) were male. In our study, the effect of effusion thickness (mm), effusion volume (ml) and shift in the midline structures on the development of recurrent haematoma on the 1st month postoperative imaging was statistically significant. The effect of the amount of protein in haematoma biochemistry sent from the haematoma during the operation on the development of recurrent haematoma was found to be statistically significant. Conclusion: We believe that identification of patients in the risk group for recurrent haematoma development will allow early detection of possible recurrent haematoma and thus early intervention before the development of symptoms in patients. In our study, radiological features and the amount of haematoma protein in the 1st month postoperative imaging were found to be significant for the risk of recurrent haematoma development. Further studies with larger patient groups are needed to better define the risk parameters. Keywords: Chronic Subdural Haematoma, Recurrent Haematoma, Haematoma Biochemistry